RESUMO
Metamizole is a drug with analgesic and antipyretic properties widely available in Portugal. Its use is highly controversial because of the risk of agranulocytosis, a rare but serious adverse event. A 70-year-old female patient with a recent history of treatment with metamizole for post-surgery fever and pain presented to the ED with sustained fever, diarrhea, and painful mouth ulcers. Laboratory tests revealed agranulocytosis. The patient was placed under protective isolation and started treatment with granulocyte-colony stimulating factor (G-CSF) and empiric antibiotic therapy with piperacillin/tazobactam and vancomycin for neutropenic fever. After an extensive workup, no source of infection was identified. During hospitalization, infectious and neoplastic causes of agranulocytosis were investigated, but the results were negative. Metamizole-induced agranulocytosis was suspected. The patient completed a total of three days of G-CSF and eight days of empiric antibiotic therapy with sustained clinical improvement. She was discharged completely asymptomatic and remained clinically stable during follow-up without a resurgence of agranulocytosis. This case report is intended to increase awareness of metamizole-induced agranulocytosis. While this is a well-known side effect, it is also often overlooked. It is paramount that both physicians and patients know how to correctly manage metamizole to prevent and promptly treat agranulocytosis.
RESUMO
This article describes a digital workflow for ceramic veneer preparation using computer-aided design and computer-aided manufacturing technology. A digital waxing was planned on the exocad software program to reestablish esthetic and functional parameters. Then, the digital guides for veneer preparation were designed by using the Meshmixer design software program to control the tooth structure removed during preparation to the minimal thickness necessary for the definitive restorations. The digital guides were printed in an additively manufactured clear resin and used in the preparation appointment, allowing a more conservative and controlled preparation.
RESUMO
Objetivo: analisar a percepção das mães quanto ao serviço de promoção do aleitamento materno. Método: pesquisa qualitativa realizada na Unidade de Saúde da Família San Martin Povo de Deus, em Recife-PE envolvendo 18 genitoras que tiveram filhos nascidos de julho a dezembro de 2009, após aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Pernambuco, sob o Protocolo n. 350/09. Elegeu-se o grupo focal com técnica de investigação e o material empírico obtido foi submetido à Técnica de Análise de Conteúdo, modalidade temática. Resultado: evidenciou-se que as ações desenvolvidas no serviço são satisfatórias, como a realização de palestras, orientação e visitas. Foi relevante a importância das visitas ao domicílio como apoio nos momentos de colocar em prática os conhecimentos adquiridos. No entanto, as mães apontaram a necessidade de inserção dos outros membros da família nas atividades educativas para que também obtenham conhecimentos e desmistifiquem algumas crendices sobre a prática do aleitamento materno. Conclusão: essas questões levam à reflexão acerca das estratégias utilizadas para abordar o tema, que envolvem a participação e corresponsabilização de outros membros da família para o sucesso da amamentação.(AU)
Objective: to analyze the mothers perception with regard to the breastfeeding promotion service. Method: this is a qualitative research carried out at the Family Health Unit San Martin Povo de Deus, in Recife, Pernambuco, Brazil with 18 mothers who had children born from July to December 2009, after it has been approved by the Research Ethics Committee of Universidade Federal de Pernambuco under Protocol 350/09. The focal group was sampled through an investigation technique and the empiric material obtained was submitted to the Technique of Content Analysis, in its thematic modality. Results: it was highlighted that the actions performed in the service are satisfactory ones, as lectures, guidance, and visits. The home visits were relevant as a support when putting into practice the knowledge obtained. Nevertheless, the mothers pointed out the need of inserting the others family members in the educational activities so that they can acquire knowledge, too, and demystify superstitions about breastfeeding practice. Conclusion: these questions lead to a reflection concerning the strategies used to deal with the theme, which involve the participation and co-obligation of the other family members in order to achieve a successful breastfeeding outcome.(AU)
Objetivo: analizar la percepción de las madres en relación al servicio de promoción del amamantamiento materno. Método: investigación cualitativa realizada en la Unidad de Salud de la Familia San Martin Povo de Deus, Recife, Pernambuco, Brasil con progenitoras que tuvieron hijos nacidos entre julio y diciembre de 2009, después de tener sido aprobado por el Comité de Ética en Pesquisa de la Universidade Federal de Pernambuco, con el número 350/09. Fue elegido para ser el grupo focal con la técnica de investigación, y el material empírico obtenido fue sometido a la técnica de análisis de contenido, en su modalidad temática. Resultado: se evidencia que las acciones llevadas a cabo en el servicio son satisfactorias, como la realización de palestras, orientación y visitas. Fue relevante la importancia de las visitas al domicilio como apoyo en los momentos de poner en práctica los conocimientos adquiridos. En ese sentido, las progenitoras indicaron la necesidad de inserción de los demás miembros de la familia en las actividades educativas, para también obtener conocimientos y desmitificar algunas creencias acerca de la práctica del amamantamiento materno. Conclusión: estas cuestiones conducen a una reflexión acerca de las estrategias utilizadas para abordar el tema, que incluye la participación y la corresponsabilización de los otros miembros de la familia al éxito del amamantamiento.(AU)